1625 



WHO has relied less on regulations and more on the authority of 

 international biomedical consensus. This course has proven politically 

 wise in many instances, and an effective strategy: to report conclu- 

 sions of the world's health experts and to leave implementation to 

 member governments. 



Prospects and Options 



who's power resides largely in the high regard in which it is held 

 among the scientific and public health specialists of the world and its 

 acceptance as the highest forum of world medical opinion. Its limita- 

 tions lie mainly in budgetary constraints which reflect lack of priority 

 standing with governments and the general public. Public health on 

 a worldwide scale has yet to command the attention which its potential 

 for further progress would warrant. The nature of the work is undra- 

 matic; in the United States and other developed countries, disciplinary 

 development and professional status for public health and preventive 

 medicine are low compared with those of modem diagnostic and 

 curative medicine; and the public and its elected representatives are 

 apparent!}^ not aware of the miracles which have been achieved in 

 the field of preventive medicine (although the recently publicized 

 example of the People's Republic of China may be working some 

 change in this field). However, there has been an interesting recent 

 development in this area: a 3-day symposium on preventive medicine 

 held at NIH during the summer of 1975. 



SEEMING NEED OF STRONGER U.S. SUPPORT OF INTERNATIONAL 



HEALTH PROGRAMS 



Recent trends in international health activities reflect a move- 

 ment from bilateral to multilateral programs such as those of WHO, 

 PAHO, and UNDP. The Peterson Report, among other studies, 

 recommended this approach. The United States has the resources, 

 the systems skills, and the biomedical technology for greatly assisting 

 WHO to realize its full potential. For this to happen would require 

 stronger support than is now evident and more visibility at policy 

 levels of the Departments of State and HEW, in the Congress, and — ■ 

 ultimately — among the U.S. public at large. 



The foregoing assessment suggests the desirability of a national 

 debate on the issue of global health and its interrelationship with 

 national health. Such a debate, involving medical and other scientific 

 and technological, political, and economic circles, would have as its 

 principal aim the education of the American public on a matter of 

 fundamental human concern. The instrument for leading such a 

 debate and educational initiative could appropriately be a committee 

 of the Congress, or perhaps two or three committees in conjunction — • 

 one concerned primarily with international relations, another with 

 health, and a third with science and technology. 



The study of The Politics of Global Health suggests additional needs. 

 In the annual congressional scrutiny of proposed budgets for inter- 

 national health activities, cost-benefit aspects have not been suflB- 

 ciently examined — probably because of the great range and com- 

 plexity of the subject matter. A qualified research institution could 

 be enlisted to make a thorough study of the relationship between the 



